| NPI | 1265643183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8663) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AL 5403) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2014-02-10 |